AABB Urges CMS to Adopt Payment Policies That Expand Access to CAR T-Cell Therapy

AABB urged the Centers for Medicare & Medicaid Services (CMS) to adopt payment policies that would expand patient access to chimeric antigen receptor (CAR) T-cell therapy in its response to the proposed 2025 Hospital Outpatient Prospective Payment System (OPPS) rule. 

AABB called on CMS to designate a status indicator of “S” to newly proposed Category I CPT codes for CAR-T services, ensuring separate payments that reflect the significant resources hospitals invest in these critical clinical services. The association also emphasized the importance of appropriate reimbursement, urging CMS to assign Ambulatory Payment Classifications (APCs) that account for the complex, multi-step process involved in CAR-T therapy. 

Additionally, AABB strongly supported CMS’s proposal to exclude cell and gene therapies from the comprehensive APC (C-APC) packaging policy for at least one year. This exclusion would help maintain patient access to these innovative treatments as more therapies transition from pass-through status to separate payment under status indicator “K.” 

AABB believes these changes are crucial to ensuring continued patient access to vital CAR-T and other cell and gene therapies in the hospital outpatient setting. An AABB-developed summary of the 2025 OPPS proposed rule is available online.